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1110 Euclid Ave Ste 202 Cleveland OH 44115 | |
| (216) 616-1155 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1110 Euclid Ave Ste 202, Cleveland, Ohio |
| Authorized Official Name and Position | Gang Anthony Lu (PRESIDENT) |
| Authorized Official Contact | 2166161155 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1110 Euclid Ave Ste 202 Cleveland OH 44115-1626 Ph: (216) 616-1155 | 1110 Euclid Ave Ste 202 Cleveland OH 44115 Ph: (216) 616-1155 |
| NPI Number | 1235620733 |
|---|---|
| Provider Enumeration Date | 05/21/2018 |
| Last Update Date | 07/01/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235620733 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 30.025103 (Ohio) | Primary |
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